Electrosurgical instrument with restricted trigger

ABSTRACT

An apparatus for operating on tissue includes an end effector, a first actuator, and a second actuator. The end effector includes a first jaw pivotable relative to a second jaw to a closed position. The first actuator is movable from a first position to a second position to pivot the first jaw to the closed position. The first actuator engages the second actuator in the second position to selectively provide RF energy to the end effector.

BACKGROUND

A variety of surgical instruments include a tissue cutting element andone or more elements that transmit radio frequency (RF) energy to tissue(e.g., to coagulate or seal the tissue). An example of such anelectrosurgical instrument is the ENSEAL® Tissue Sealing Device byEthicon Endo-Surgery, Inc., of Cincinnati, Ohio. Further examples ofsuch devices and related concepts are disclosed in U.S. Pat. No.6,500,176 entitled “Electrosurgical Systems and Techniques for SealingTissue,” issued Dec. 31, 2002, the disclosure of which is incorporatedby reference herein; U.S. Pat. No. 7,112,201 entitled “ElectrosurgicalInstrument and Method of Use,” issued Sep. 26, 2006, the disclosure ofwhich is incorporated by reference herein; U.S. Pat. No. 7,125,409,entitled “Electrosurgical Working End for Controlled Energy Delivery,”issued Oct. 24, 2006, the disclosure of which is incorporated byreference herein; U.S. Pat. No. 7,169,146 entitled “ElectrosurgicalProbe and Method of Use,” issued Jan. 30, 2007, the disclosure of whichis incorporated by reference herein; U.S. Pat. No. 7,186,253, entitled“Electrosurgical Jaw Structure for Controlled Energy Delivery,” issuedMar. 6, 2007, the disclosure of which is incorporated by referenceherein; U.S. Pat. No. 7,189,233, entitled “Electrosurgical Instrument,”issued Mar. 13, 2007, the disclosure of which is incorporated byreference herein; U.S. Pat. No. 7,220,951, entitled “Surgical SealingSurfaces and Methods of Use,” issued May 22, 2007, the disclosure ofwhich is incorporated by reference herein; U.S. Pat. No. 7,309,849,entitled “Polymer Compositions Exhibiting a PTC Property and Methods ofFabrication,” issued Dec. 18, 2007, the disclosure of which isincorporated by reference herein; U.S. Pat. No. 7,311,709, entitled“Electrosurgical Instrument and Method of Use,” issued Dec. 25, 2007,the disclosure of which is incorporated by reference herein; U.S. Pat.No. 7,354,440, entitled “Electrosurgical Instrument and Method of Use,”issued Apr. 8, 2008, the disclosure of which is incorporated byreference herein; U.S. Pat. No. 7,381,209, entitled “ElectrosurgicalInstrument,” issued Jun. 3, 2008, the disclosure of which isincorporated by reference herein.

Additional examples of electrosurgical cutting instruments and relatedconcepts are disclosed in U.S. Pub. No. 2011/0087218, entitled “SurgicalInstrument Comprising First and Second Drive Systems Actuatable by aCommon Trigger Mechanism,” published Apr. 14, 2011, the disclosure ofwhich is incorporated by reference herein; U.S. Pub. No. 2012/0083783,entitled “Surgical Instrument with Jaw Member,” published Apr. 5, 2012,the disclosure of which is incorporated by reference herein; U.S. Pub.No. 2012/0116379, entitled “Motor Driven Electrosurgical Device withMechanical and Electrical Feedback,” published May 10, 2012, thedisclosure of which is incorporated by reference herein; U.S. Pub. No.2012/0078243, entitled “Control Features for Articulating SurgicalDevice,” published Mar. 29, 2012, the disclosure of which isincorporated by reference herein; U.S. Pub. No. 2012/0078247, entitled“Articulation Joint Features for Articulating Surgical Device,”published Mar. 29, 2012, the disclosure of which is incorporated byreference herein; U.S. Pub. No. 2013/0030428, entitled “SurgicalInstrument with Multi-Phase Trigger Bias,” published Jan. 31, 2013, thedisclosure of which is incorporated by reference herein; and U.S. Pub.No. 2013/0023868, entitled “Surgical Instrument with Contained DualHelix Actuator Assembly,” published Jan. 31, 2013, the disclosure ofwhich is incorporated by reference herein.

While a variety of surgical instruments have been made and used, it isbelieved that no one prior to the inventors has made or used theinvention described in the appended claims.

BRIEF DESCRIPTION OF THE DRAWINGS

While the specification concludes with claims which particularly pointout and distinctly claim this technology, it is believed this technologywill be better understood from the following description of certainexamples taken in conjunction with the accompanying drawings, in whichlike reference numerals identify the same elements and in which:

FIG. 1 depicts a side elevational view of an exemplary electrosurgicalmedical instrument;

FIG. 2 depicts a perspective view of the end effector of the instrumentof FIG. 1, in an open configuration;

FIG. 3 depicts another perspective view of the end effector of theinstrument of FIG. 1, in an open configuration;

FIG. 4 depicts a cross-sectional end view of the end effector of FIG. 2,in a closed configuration and with the blade in a distal position;

FIG. 5 depicts a partial perspective view of the distal end of anexemplary alternative firing beam suitable for incorporation in theinstrument of FIG. 1;

FIG. 6 depicts a cross-sectional view of an exemplary handpiece for usewith the instrument of FIG. 1 in an initial position;

FIG. 7 depicts a cross-sectional view of a housing of the handpiece ofFIG. 6;

FIG. 8 depicts a perspective view of a trigger of the handpiece of FIG.6;

FIG. 9 depicts a side elevational view of the trigger of FIG. 8;

FIG. 10 depicts a perspective view of a pivot arm of the handpiece ofFIG. 6;

FIG. 11 depicts a side elevational view of the pivot arm of FIG. 10;

FIG. 12 depicts a perspective view of a translation member of thehandpiece of

FIG. 6;

FIG. 13 depicts a side elevational view of the translation member ofFIG. 12;

FIG. 14 depicts a top plan view of the translation member of FIG. 12;

FIG. 15 depicts a side elevational view of the trigger coupled to aplate of the handpiece of FIG. 6;

FIG. 16A depicts a partial cross-sectional view of the handpiece of FIG.6 in the initial position;

FIG. 16B depicts a partial cross-sectional view of the handpiece of FIG.6 in a fired position;

FIG. 17 depicts a cross-sectional view of the handpiece of FIG. 6 in thefired position; and

FIG. 18 depicts a cross-sectional view of the handpiece of FIG. 6 in afired and de-energized state.

The drawings are not intended to be limiting in any way, and it iscontemplated that various embodiments of the technology may be carriedout in a variety of other ways, including those not necessarily depictedin the drawings. The accompanying drawings incorporated in and forming apart of the specification illustrate several aspects of the presenttechnology, and together with the description serve to explain theprinciples of the technology; it being understood, however, that thistechnology is not limited to the precise arrangements shown.

DETAILED DESCRIPTION

The following description of certain examples of the technology shouldnot be used to limit its scope. Other examples, features, aspects,embodiments, and advantages of the technology will become apparent tothose skilled in the art from the following description, which is by wayof illustration, one of the best modes contemplated for carrying out thetechnology. As will be realized, the technology described herein iscapable of other different and obvious aspects, all without departingfrom the technology. Accordingly, the drawings and descriptions shouldbe regarded as illustrative in nature and not restrictive.

It is further understood that any one or more of the teachings,expressions, embodiments, examples, etc. described herein may becombined with any one or more of the other teachings, expressions,embodiments, examples, etc. that are described herein. Thefollowing-described teachings, expressions, embodiments, examples, etc.should therefore not be viewed in isolation relative to each other.Various suitable ways in which the teachings herein may be combined willbe readily apparent to those of ordinary skill in the art in view of theteachings herein. Such modifications and variations are intended to beincluded within the scope of the claims.

For clarity of disclosure, the terms “proximal” and “distal” are definedherein relative to a surgeon or other operator grasping a surgicalinstrument having a distal surgical end effector. The term “proximal”refers the position of an element closer to the surgeon or otheroperator and the term “distal” refers to the position of an elementcloser to the surgical end effector of the surgical instrument andfurther away from the surgeon or other operator.

I. Exemplary Electrosurgical Device with Articulation Feature

FIGS. 1-4 show an exemplary electrosurgical instrument (10) that isconstructed and operable in accordance with at least some of theteachings of U.S. Pat. No. 6,500,176; U.S. Pat. No. 7,112,201; U.S. Pat.No. 7,125,409; U.S. Pat. No. 7,169,146; U.S. Pat. No. 7,186,253; U.S.Pat. No. 7,189,233; U.S. Pat. No. 7,220,951; U.S. Pat. No. 7,309,849;U.S. Pat. No. 7,311,709; U.S. Pat. No. 7,354,440; U.S. Pat. No.7,381,209; U.S. Pub. No. 2011/0087218; U.S. Pub. No. 2012/0083783; U.S.Pub. No. 2012/0116379; U.S. Pub. No. 2012/0078243; U.S. Pub. No.2012/0078247; U.S. Pub. No. 2013/0030428; and/or U.S. Pub. No.2013/0023868. As described therein and as will be described in greaterdetail below, electrosurgical instrument (10) is operable to cut tissueand seal or weld tissue (e.g., a blood vessel, etc.) substantiallysimultaneously. In other words, electrosurgical instrument (10) operatessimilar to an endocutter type of stapler, except that electrosurgicalinstrument (10) provides tissue welding through application of bipolarRF energy instead of providing lines of staples to join tissue. Itshould also be understood that electrosurgical instrument (10) may havevarious structural and functional similarities with the ENSEAL® TissueSealing Device by Ethicon Endo-Surgery, Inc., of Cincinnati, Ohio.Furthermore, electrosurgical instrument (10) may have various structuraland functional similarities with the devices taught in any of the otherreferences that are cited and incorporated by reference herein. To theextent that there is some degree of overlap between the teachings of thereferences cited herein, the ENSEAL® Tissue Sealing Device by EthiconEndo-Surgery, Inc., of Cincinnati, Ohio, and the following teachingsrelating to electrosurgical instrument (10), there is no intent for anyof the description herein to be presumed as admitted prior art. Severalteachings below will in fact go beyond the scope of the teachings of thereferences cited herein and the ENSEAL® Tissue Sealing Device by EthiconEndo-Surgery, Inc., of Cincinnati, Ohio.

A. Exemplary Handpiece and Shaft

Electrosurgical instrument (10) of the present example includes ahandpiece (20), a shaft (30) extending distally from handpiece (20), andan end effector (40) disposed at a distal end of shaft (30). Handpiece(20) of the present example includes a pistol grip (22), a pivotingtrigger (24), an activation button (26), and an articulation control(28). Trigger (24) is pivotable toward and away from pistol grip (22) toselectively actuate end effector (40) as will be described in greaterdetail below. Activation button (26) is operable to selectively activateRF circuitry that is in communication with end effector (40), as willalso be described in greater detail below. In some versions, activationbutton (26) also serves as a mechanical lockout against trigger (24),such that trigger (24) cannot be fully actuated unless button (26) isbeing pressed simultaneously. Examples of how such a lockout may beprovided are disclosed in one or more of the references cited herein. Inaddition or in the alternative, trigger (24) may serve as an electricaland/or mechanical lockout against button (26), such that button (26)cannot be effectively activated unless trigger (24) is being squeezedsimultaneously. It should be understood that pistol grip (22), trigger(24), and button (26) may be modified, substituted, supplemented, etc.in any suitable way, and that the descriptions of such components hereinare merely illustrative.

Shaft (30) of the present example includes a rigid outer sheath (32) andan articulation section (36). Articulation section (36) is operable toselectively laterally deflect end effector (40) at various anglesrelative to the longitudinal axis defined by sheath (32). In someversions, articulation section (36) and/or some other portion of outersheath (32) includes a flexible outer sheath (e.g., a heat shrink tube,etc.) disposed about its exterior. Articulation section (36) of shaft(30) may take a variety of forms. By way of example only, articulationsection (36) may be configured in accordance with one or more teachingsof U.S. Pub. No. 2012/0078247, the disclosure of which is incorporatedby reference herein. As another merely illustrative example,articulation section (36) may be configured in accordance with one ormore teachings of U.S. Pub. No. 2012/0078248, entitled “ArticulationJoint Features for Articulating Surgical Device,” published Mar. 29,2012, the disclosure of which is incorporated by reference herein.Various other suitable forms that articulation section (36) may takewill be apparent to those of ordinary skill in the art in view of theteachings herein. It should also be understood that some versions ofinstrument (10) may simply lack articulation section (36).

In some versions, shaft (30) is also rotatable about the longitudinalaxis defined by sheath (32), relative to handpiece (20), via a knob(34). Such rotation may provide rotation of end effector (40) and shaft(30) unitarily. In some other versions, knob (34) is operable to rotateend effector (40) without rotating articulation section (36) or anyportion of shaft (30) that is proximal of articulation section (36). Asanother merely illustrative example, electrosurgical instrument (10) mayinclude one rotation control that provides rotatability of shaft (30)and end effector (40) as a single unit; and another rotation controlthat provides rotatability of end effector (40) without rotatingarticulation section (36) or any portion of shaft (30) that is proximalof articulation section (36). Other suitable rotation schemes will beapparent to those of ordinary skill in the art in view of the teachingsherein. Of course, rotatable features may simply be omitted if desired.

Articulation control (28) of the present example is operable toselectively control articulation section (36) of shaft (30), to therebyselectively laterally deflect end effector (40) at various anglesrelative to the longitudinal axis defined by shaft (30). Whilearticulation control (28) is in the form of a rotary dial in the presentexample, it should be understood that articulation control (28) may takenumerous other forms. By way of example only, some merely illustrativeforms that articulation control (28) and other components of handpiece(20) may take are disclosed in U.S. Pub. No. 2012/0078243, thedisclosure of which is incorporated by reference herein; in U.S. Pub.No. 2012/0078244, entitled “Control Features for Articulating SurgicalDevice,” published Mar. 29, 2012, the disclosure of which isincorporated by reference herein; and in U.S. Pub. No. 2013/0023868, thedisclosure of which is incorporated by reference herein. Still othersuitable forms that articulation control (28) may take will be apparentto those of ordinary skill in the art in view of the teachings herein.It should also be understood that some versions of instrument (10) maysimply lack an articulation control (28).

B. Exemplary End Effector

End effector (40) of the present example comprises a first jaw (42) anda second jaw (44). In the present example, first jaw (42) issubstantially fixed relative to shaft (30); while second jaw (44) pivotsrelative to shaft (30), toward and away from first jaw (42). Use of theterm “pivot” should not be read as necessarily requiring pivotalmovement about a fixed axis. In some versions, second jaw (44) pivotsabout an axis that is defined by a pin (or similar feature) that slidesalong an elongate slot or channel as second jaw (44) moves toward firstjaw (42). In such versions, the pivot axis translates along the pathdefined by the slot or channel while second jaw (44) simultaneouslypivots about that axis. It should be understood that suchsliding/translating pivotal movement is encompassed within terms such as“pivot,” “pivots,” “pivotal,” “pivotable,” “pivoting,” and the like. Ofcourse, some versions may provide pivotal movement of second jaw (44)about an axis that remains fixed and does not translate within a slot orchannel, etc.

In some versions, actuators such as rods or cables, etc., may extendthrough sheath (32) and be joined with second jaw (44) at a pivotalcoupling (43), such that longitudinal movement of the actuatorrods/cables/etc. through shaft (30) provides pivoting of second jaw (44)relative to shaft (30) and relative to first jaw (42). Of course, jaws(42, 44) may instead have any other suitable kind of movement and may beactuated in any other suitable fashion. By way of example only, and aswill be described in greater detail below, jaws (42, 44) may be actuatedand thus closed by longitudinal translation of a firing beam (60), suchthat actuator rods/cables/etc. may simply be eliminated in someversions.

As best seen in FIGS. 2-4, first jaw (42) defines a longitudinallyextending elongate slot (46); while second jaw (44) also defines alongitudinally extending elongate slot (48). In addition, the top sideof first jaw (42) presents a first electrode surface (50); while theunderside of second jaw (44) presents a second electrode surface (52).Electrode surfaces (50, 52) are in communication with an electricalsource (80) via one or more conductors (not shown) that extend along thelength of shaft (30). These conductors are coupled with electricalsource (80) and a controller (82) via a cable (84), which extendsproximally from handpiece (20). Electrical source (80) is operable todeliver RF energy to first electrode surface (50) at a first polarityand to second electrode surface (52) at a second (opposite) polarity,such that RF current flows between electrode surfaces (50, 52) andthereby through tissue captured between jaws (42, 44). In some versions,firing beam (60) serves as an electrical conductor that cooperates withelectrode surfaces (50, 52) (e.g., as a ground return) for delivery ofbipolar RF energy captured between jaws (42, 44). Electrical source (80)may be external to electrosurgical instrument (10) or may be integralwith electrosurgical instrument (10) (e.g., in handpiece (20), etc.), asdescribed in one or more references cited herein or otherwise. Acontroller (82) regulates delivery of power from electrical source (80)to electrode surfaces (50, 52). Controller (82) may also be external toelectrosurgical instrument (10) or may be integral with electrosurgicalinstrument (10) (e.g., in handpiece (20), etc.), as described in one ormore references cited herein or otherwise. It should also be understoodthat electrode surfaces (50, 52) may be provided in a variety ofalternative locations, configurations, and relationships.

By way of example only, power source (80) and/or controller (82) may beconfigured in accordance with at least some of the teachings of U.S.Provisional Pat. App. No. 61/550,768, entitled “Medical Instrument,”filed Oct. 24, 2011, the disclosure of which is incorporated byreference herein; U.S. Pub. No. 2011/0082486, entitled “Devices andTechniques for Cutting and Coagulating Tissue,” published Apr. 7, 2011,the disclosure of which is incorporated by reference herein; U.S. Pub.No. 2011/0087212, entitled “Surgical Generator for Ultrasonic andElectrosurgical Devices,” published Apr. 14, 2011, the disclosure ofwhich is incorporated by reference herein; U.S. Pub. No. 2011/0087213,entitled “Surgical Generator for Ultrasonic and ElectrosurgicalDevices,” published Apr. 14, 2011, the disclosure of which isincorporated by reference herein; U.S. Pub. No. 2011/0087214, entitled“Surgical Generator for Ultrasonic and Electrosurgical Devices,”published Apr. 14, 2011, the disclosure of which is incorporated byreference herein; U.S. Pub. No. 2011/0087215, entitled “SurgicalGenerator for Ultrasonic and Electrosurgical Devices,” published Apr.14, 2011, the disclosure of which is incorporated by reference herein;U.S. Pub. No. 2011/0087216, entitled “Surgical Generator for Ultrasonicand Electrosurgical Devices,” published Apr. 14, 2011, the disclosure ofwhich is incorporated by reference herein; and/or U.S. Pub. No.2011/0087217, entitled “Surgical Generator for Ultrasonic andElectrosurgical Devices,” published Apr. 14, 2011, the disclosure ofwhich is incorporated by reference herein. Other suitable configurationsfor power source (80) and controller (82) will be apparent to those ofordinary skill in the art in view of the teachings herein.

As best seen in FIG. 4, the lower side of first jaw (42) includes alongitudinally extending recess (58) adjacent to slot (46); while theupper side of second jaw (44) includes a longitudinally extending recess(59) adjacent to slot (48). FIG. 2 shows the upper side of first jaw(42) including a plurality of teeth serrations (46). It should beunderstood that the lower side of second jaw (44) may includecomplementary serrations that nest with serrations (46), to enhancegripping of tissue captured between jaws (42, 44) without necessarilytearing the tissue. In other words, it should be understood thatserrations may be generally blunt or otherwise atraumatic. FIG. 3 showsan example of serrations (46) in first jaw (42) as mainly recesses; withserrations (48) in second jaw (44) as mainly protrusions. Of course,serrations (46, 48) may take any other suitable form or may be simplyomitted altogether. It should also be understood that serrations (46,48) may be formed of an electrically non-conductive, or insulative,material, such as plastic, glass, and/or ceramic, for example, and mayinclude a treatment such as polytetrafluoroethylene, a lubricant, orsome other treatment to substantially prevent tissue from getting stuckto jaws (42, 44).

With jaws (42, 44) in a closed position, shaft (30) and end effector(40) are sized and configured to fit through trocars having variousinner diameters, such that electrosurgical instrument (10) is usable inminimally invasive surgery, though of course electrosurgical instrument(10) could also be used in open procedures if desired. By way of exampleonly, with jaws (42, 44) in a closed position, shaft (30) and endeffector (40) may present an outer diameter of approximately 5 mm.Alternatively, shaft (30) and end effector (40) may present any othersuitable outer diameter (e.g., between approximately 2 mm andapproximately 20 mm, etc.).

As another merely illustrative variation, either jaw (42, 44) or both ofjaws (42, 44) may include at least one port, passageway, conduit, and/orother feature that is operable to draw steam, smoke, and/or othergases/vapors/etc. from the surgical site. Such a feature may be incommunication with a source of suction, such as an external source or asource within handpiece (20), etc. In addition, end effector (40) mayinclude one or more tissue cooling features (not shown) that reduce thedegree or extent of thermal spread caused by end effector (40) onadjacent tissue when electrode surfaces (50, 52) are activated. Varioussuitable forms that such cooling features may take will be apparent tothose of ordinary skill in the art in view of the teachings herein.

In some versions, end effector (40) includes one or more sensors (notshown) that are configured to sense a variety of parameters at endeffector (40), including but not limited to temperature of adjacenttissue, electrical resistance or impedance of adjacent tissue, voltageacross adjacent tissue, forces exerted on jaws (42, 44) by adjacenttissue, etc. By way of example only, end effector (40) may include oneor more positive temperature coefficient (PTC) thermistor bodies (54,56) (e.g., PTC polymer, etc.), located adjacent to electrodes (50, 52)and/or elsewhere. Data from sensors may be communicated to controller(82). Controller (82) may process such data in a variety of ways. By wayof example only, controller (82) may modulate or otherwise change the RFenergy being delivered to electrode surfaces (50, 52), based at least inpart on data acquired from one or more sensors at end effector (40). Inaddition or in the alternative, controller (82) may alert the user toone or more conditions via an audio and/or visual feedback device (e.g.,speaker, lights, display screen, etc.), based at least in part on dataacquired from one or more sensors at end effector (40). It should alsobe understood that some kinds of sensors need not necessarily be incommunication with controller (82), and may simply provide a purelylocalized effect at end effector (40). For instance, a PTC thermistorbodies (54, 56) at end effector (40) may automatically reduce the energydelivery at electrode surfaces (50, 52) as the temperature of the tissueand/or end effector (40) increases, thereby reducing the likelihood ofoverheating. In some such versions, a PTC thermistor element is inseries with power source (80) and electrode surface (50, 52); and thePTC thermistor provides an increased impedance (reducing flow ofcurrent) in response to temperatures exceeding a threshold. Furthermore,it should be understood that electrode surfaces (50, 52) may be used assensors (e.g., to sense tissue impedance, etc.). Various kinds ofsensors that may be incorporated into electrosurgical instrument (10)will be apparent to those of ordinary skill in the art in view of theteachings herein. Similarly various things that can be done with datafrom sensors, by controller (82) or otherwise, will be apparent to thoseof ordinary skill in the art in view of the teachings herein. Othersuitable variations for end effector (40) will also be apparent to thoseof ordinary skill in the art in view of the teachings herein.

C. Exemplary Firing Beam

As also seen in FIGS. 2-4, electrosurgical instrument (10) of thepresent example includes a firing beam (60) that is longitudinallymovable along part of the length of end effector (40). Firing beam (60)is coaxially positioned within shaft (30), extends along the length ofshaft (30), and translates longitudinally within shaft (30) (includingarticulation section (36) in the present example), though it should beunderstood that firing beam (60) and shaft (30) may have any othersuitable relationship. In some versions, a proximal end of firing beam(60) is secured to a firing tube or other structure within shaft (30);and the firing tube or other structure extends through the remainder ofshaft (30) to handpiece (20) where it is driven by movement of trigger(24). Firing beam (60) includes a sharp distal blade (64), an upperflange (62), and a lower flange (66). As best seen in FIG. 4, distalblade (64) extends through slots (46, 48) of jaws (42, 44), with upperflange (62) being located above jaw (44) in recess (59) and lower flange(66) being located below jaw (42) in recess (58). The configuration ofdistal blade (64) and flanges (62, 66) provides an “I-beam” type ofcross section at the distal end of firing beam (60). While flanges (62,66) extend longitudinally only along a small portion of the length offiring beam (60) in the present example, it should be understood thatflanges (62, 66) may extend longitudinally along any suitable length offiring beam (60). In addition, while flanges (62, 66) are positionedalong the exterior of jaws (42, 44), flanges (62, 66) may alternativelybe disposed in corresponding slots formed within jaws (42, 44). Forinstance, each jaw (42, 44) may define a “T”-shaped slot, with parts ofdistal blade (64) being disposed in one vertical portion of each“T”-shaped slot and with flanges (62, 66) being disposed in thehorizontal portions of the “T”-shaped slots. Various other suitableconfigurations and relationships will be apparent to those of ordinaryskill in the art in view of the teachings herein.

Distal blade (64) is substantially sharp, such that distal blade (64)will readily sever tissue that is captured between jaws (42, 44). Distalblade (64) is also electrically grounded in the present example,providing a return path for RF energy as described elsewhere herein. Insome other versions, distal blade (64) serves as an active electrode. Inaddition or in the alternative, distal blade (64) may be selectivelyenergized with ultrasonic energy (e.g., harmonic vibrations atapproximately 55.5 kHz, etc.).

The “I-beam” type of configuration of firing beam (60) provides closureof jaws (42, 44) as firing beam (60) is advanced distally. Inparticular, flange (62) urges jaw (44) pivotally toward jaw (42) asfiring beam (60) is advanced from a proximal position (FIGS. 1-3) to adistal position (FIG. 4), by bearing against recess (59) formed in jaw(44). This closing effect on jaws (42, 44) by firing beam (60) may occurbefore distal blade (64) reaches tissue captured between jaws (42, 44).Such staging of encounters by firing beam (60) may reduce the forcerequired to squeeze trigger (24) to actuate firing beam (60) through afull firing stroke. In other words, in some such versions, firing beam(60) may have already overcome an initial resistance required tosubstantially close jaws (42, 44) on tissue before encounteringresistance from severing the tissue captured between jaws (42, 44). Ofcourse, any other suitable staging may be provided.

In the present example, flange (62) is configured to cam against a rampfeature at the proximal end of jaw (44) to open jaw (44) when firingbeam (60) is retracted to a proximal position and to hold jaw (44) openwhen firing beam (60) remains at the proximal position. This cammingcapability may facilitate use of end effector (40) to separate layers oftissue, to perform blunt dissections, etc., by forcing jaws (42, 44)apart from a closed position. In some other versions, jaws (42, 44) areresiliently biased to an open position by a spring or other type ofresilient feature. While jaws (42, 44) close or open as firing beam (60)is translated in the present example, it should be understood that otherversions may provide independent movement of jaws (42, 44) and firingbeam (60). By way of example only, one or more cables, rods, beams, orother features may extend through shaft (30) to selectively actuate jaws(42, 44) independently of firing beam (60). Such jaw (42, 44) actuationfeatures may be separately controlled by a dedicated feature ofhandpiece (20). Alternatively, such jaw actuation features may becontrolled by trigger (24) in addition to having trigger (24) controlfiring beam (60). It should also be understood that firing beam (60) maybe resiliently biased to a proximal position, such that firing beam (60)retracts proximally when a user relaxes their grip on trigger (24).

FIG. 5 shows an exemplary alternative firing beam (70), which may bereadily substituted for firing beam (60). In this example, firing beam(70) comprises a blade insert (94) that is interposed between two beamplates (90, 92). Blade insert (94) includes a sharp distal edge (96),such that blade insert (94) will readily sever tissue that is capturedbetween jaws (42, 44). Sharp distal edge (96) is exposed by a proximallyextending recess (93) formed in plates (90, 92). A set of pins (72, 74,76) are transversely disposed in plates (90, 92). Pins (72, 74) togethereffectively serve as substitutes for upper flange (62); while pin (76)effectively serves as a substitute for lower flange (66). Thus, pins(72, 74) bear against channel (59) of jaw (44), and pin (76) bearsagainst channel (58) of jaw (42), as firing beam (70) is translateddistally through slots (46, 48). Pins (72, 74, 76) of the presentexample are further configured to rotate within plates (90, 92), aboutthe axes respectively defined by pins (72, 74, 76). It should beunderstood that such rotatability of pins (72, 74, 76) may providereduced friction with jaws (42, 44), thereby reducing the force requiredto translate firing beam (70) distally and proximally in jaws (42, 44).Pin (72) is disposed in an angled elongate slot (98) formed throughplates (90, 92), such that pin (72) is translatable along slot (98). Inparticular, pin (72) is disposed in the proximal portion of slot (98) asfiring beam (70) is being translated distally. When firing beam (70) istranslated proximally, pin (72) slides distally and upwardly in slot(98), increasing the vertical separation between pins (72, 76), which inturn reduces the compressive forces applied by jaws (42, 44) and therebyreduces the force required to retract firing beam (70). Of course,firing beam (70) may have any other suitable configuration. By way ofexample only, firing beam (70) may be configured in accordance with atleast some of the teachings of U.S. Pub. No. 2012/0083783, thedisclosure of which is incorporated by reference herein.

D. Exemplary Operation

In an exemplary use, end effector (40) is inserted into a patient via atrocar. Articulation section (36) is substantially straight when endeffector (40) and part of shaft (30) are inserted through the trocar.Articulation control (28) may then be manipulated to pivot or flexarticulation section (36) of shaft (30) in order to position endeffector (40) at a desired position and orientation relative to ananatomical structure within the patient. Two layers of tissue of theanatomical structure are then captured between jaws (42, 44) bysqueezing trigger (24) toward pistol grip (22). Such layers of tissuemay be part of the same natural lumen defining anatomical structure(e.g., blood vessel, portion of gastrointestinal tract, portion ofreproductive system, etc.) in a patient. For instance, one tissue layermay comprise the top portion of a blood vessel while the other tissuelayer may comprise the bottom portion of the blood vessel, along thesame region of length of the blood vessel (e.g., such that the fluidpath through the blood vessel before use of electrosurgical instrument(10) is perpendicular to the longitudinal axis defined by end effector(40), etc.). In other words, the lengths of jaws (42, 44) may beoriented perpendicular to (or at least generally transverse to) thelength of the blood vessel. As noted above, flanges (62, 66) camminglyact to pivot jaw (42) toward jaw (44) when firing beam (60) is actuateddistally by squeezing trigger (24) toward pistol grip (22). Jaws (42,44) may be substantially clamping tissue before trigger (24) has sweptthrough a full range of motion toward pistol grip (22), such thattrigger (24) may continue pivoting toward pistol grip (22) through asubsequent range of motion after jaws (42, 44) have substantiallyclamped on the tissue.

With tissue layers captured between jaws (42, 44) firing beam (60)continues to advance distally by the user squeezing trigger (24) furthertoward pistol grip (22). As firing beam (60) continues to advancedistally, distal blade (64) simultaneously severs the clamped tissuelayers, resulting in separated upper layer portions being apposed withrespective separated lower layer portions. In some versions, thisresults in a blood vessel being cut in a direction that is generallytransverse to the length of the blood vessel. It should be understoodthat the presence of flanges (62, 66) immediately above and below jaws(42, 44), respectively, may help keep jaws (42, 44) in a closed andtightly clamping position. In particular, flanges (62, 66) may helpmaintain a significantly compressive force between jaws (42, 44). Withsevered tissue layer portions being compressed between jaws (42, 44),electrode surfaces (50, 52) are activated with bipolar RF energy by theuser depressing activation button (26). In some versions, electrodes(50, 52) are selectively coupled with power source (80) (e.g., by theuser depressing button (26), etc.) such that electrode surfaces (50, 52)of jaws (42, 44) are activated with a common first polarity while firingbeam (60) is activated at a second polarity that is opposite to thefirst polarity. Thus, a bipolar RF current flows between firing beam(60) and electrode surfaces (50, 52) of jaws (42, 44), through thecompressed regions of severed tissue layer portions. In some otherversions, electrode surface (50) has one polarity while electrodesurface (52) and firing beam (60) both have the other polarity. Ineither version (among at least some others), bipolar RF energy deliveredby power source (80) ultimately thermally welds the tissue layerportions on one side of firing beam (60) together and the tissue layerportions on the other side of firing beam (60) together.

In certain circumstances, the heat generated by activated electrodesurfaces (50, 52) can denature the collagen within the tissue layerportions and, in cooperation with clamping pressure provided by jaws(42, 44), the denatured collagen can form a seal within the tissue layerportions. Thus, the severed ends of the natural lumen defininganatomical structure are hemostatically sealed shut, such that thesevered ends will not leak bodily fluids. In some versions, electrodesurfaces (50, 52) may be activated with bipolar RF energy before firingbeam (60) even begins to translate distally and thus before the tissueis even severed. For instance, such timing may be provided in versionswhere button (26) serves as a mechanical lockout relative to trigger(24) in addition to serving as a switch between power source (80) andelectrode surfaces (50, 52). Other suitable ways in which instrument(10) may be operable and operated will be apparent to those of ordinaryskill in the art in view of the teachings herein.

II. Exemplary Instrument with Automatic RF Energy

In some instances, it may be desirable to activate electrode surfaces(50, 52) with bipolar RF energy automatically when jaws (42, 44) of endeffector (40) are closed. This may prevent inadvertent firing (i.e.distal advancement) of firing beam (14) and cutting edge (48) to severtissue positioned between jaws (42, 44) without thermally welding thetissue. This may also avoid requiring the operator to actuate a separateuser input feature (e.g., like button (26), etc.) to activate RF energy.Accordingly, RF energy features may be provided within instrument (10)to automatically initiate thermal welding of tissue positioned betweenjaws (42, 44) when jaws (42, 44) are closed. The examples below includeseveral merely illustrative versions of automatic RF energy featuresthat may be readily introduced to an instrument (10).

A. Exemplary Handpiece

FIG. 6 shows an exemplary handpiece (120) with automatic RF energyfeatures.

Handpiece (120) is similar to handpiece (20) in that handpiece (120)comprises a pistol grip (122) and a trigger (126) that is pivotabletoward and away from pistol grip (122) to selectively actuate endeffector (40). In the present example, pistol grip (122) is coupled witha housing (123) comprising a plate (140). As shown in FIG. 7, plate(140) comprises a pin (128) and an opening (124). Pin (128) isconfigured for receipt in an opening (162) of a pivot arm (160). Opening(124) comprises a first recess (125) and a second recess (127). Firstrecess (125) is configured to receive an actuator (131) of trigger (126)such that actuator (131) is rotatable and translatable within firstrecess (125). In other words, actuator (131) acts as a floating pivotwithin recess (125). Second recess (127) is configured to receive aswitch (170). Switch (170) is operable to selectively activate electrodesurfaces (50, 52) of end effector (40) with bipolar RF energy.Accordingly, as actuator (131) of trigger (126) rotates and translateswithin opening (124), actuator (131) is configured to selectively engageswitch (170) to activate and/or deactivate electrode surfaces (50, 52).

FIGS. 8-9 show trigger (126) in greater detail. Trigger (126) comprisesan arm (135) extending within housing (123). The top portion of arm(135) comprises an actuator (131) and a protrusion (137). Actuator (131)is substantially circular and is configured to rotate and translatewithin opening (124) of housing (123). Accordingly, actuator (131)selectively engages switch (170) to activate electrode surfaces (50, 52)with bipolar RF energy. For example, actuator (131) may be in a proximalposition such that actuator (131) is decoupled from switch (170) suchthat no RF energy is supplied to electrode surfaces (50, 52). Trigger(126) may then be pivoted toward grip (122) such that actuator (131)rotates and translates distally within opening (124) to engage andcompress switch (170) to apply RF energy to electrode surfaces (50, 52).When trigger (126) is released and pivoted away from grip (122),actuator (131) may return to the proximal position to release switch(170) and again deactivate electrode surfaces (50, 52). A protrusion(133) extends from actuator (131). Protrusion (133) is configured torotate and translate within first recess (125) opening (124) to preventactuator (131) from engaging switch (170) prior to closure of jaws (42,44). The opposing side of the top portion of trigger arm (135) comprisesa protrusion (137) extending from arm (135). A pin (136) extends from aside portion of arm (135). The lower portion of arm (135) comprises achannel (138) to receive a protrusion (163) of pivot arm (160).

As shown in FIGS. 10-11, pivot arm (160) comprises opening (162) andprotrusions (163, 164). Opening (162) is positioned on pin (128) ofplate (140) within housing (123) such that pivot arm (160) is pivotablerelative to pin (128). A first protrusion (163) extends from a lowerportion of pivot arm (160). First protrusion (163) is configured toextend within channel (138) of trigger arm (135). Accordingly, a usermay pivot trigger (126) toward and/or away from grip (122) to therebypivot arm (160) with trigger (126). A second protrusion (164) extendsfrom a top portion of pivot arm (160) to extend within translationmember (150). Translation member (150) thereby translates upon rotationof pivot arm (160).

Translation member (150) comprises a channel (152) extending throughtranslation member (150) to receive second protrusion (164) of pivot arm(160), as shown in FIGS. 12-14. Translation member (150) furthercomprises arms (154, 156) extending distally from translation member(150), as best seen in FIG. 13. First arm (154) extends outwardly anddownwardly from a top portion of the distal end of translation member(150). Second arm (156) extends outwardly and upwardly from a lowerportion of the distal end of translation member (150). Arms (154, 156)may therefore receive the proximal end of firing beam (190), as shown inFIG. 6. Firing beam (190) is substantially similar to firing beam (60),except that the proximal end of firing beam (190) comprises a knob(192). Knob (192) is positioned within arms (154, 156) of translationmember (150) to maintain the longitudinal position of firing beam (190)relative to translation member (150). Accordingly, translation member(150) is operable to translate firing beam (190). A compression spring(180) is positioned around firing beam (190) distal to arms (154, 156)of translation member (150). Compression spring (180) is configured toresiliently bias translation member (150) proximally to an initialposition such that jaws (42, 44) are open. Pins (155, 157) extend from abottom surface of translation member (150), as shown in FIG. 13. Pins(155, 157) engage plate (140) of housing (123) such that translationmember (150) is translatable proximally and/or distally relative toplate (140).

In the present example, a torsion spring (182) is further provided toresiliently bias trigger (126) to the initial position such that jaws(42, 44) are open, as shown in FIG. 15. Torsion spring (182) ispositioned around protrusion (137) of trigger arm (135). One end oftorsion spring (182) rests against pin (136) on the side portion oftrigger arm (135). The opposing end of torsion spring (182) restsagainst a pin (142) extending from plate (140). Accordingly, as trigger(126) is pivoted toward grip (122), torsion spring (182) is compressedto resiliently bias trigger (126) back to the initial position away fromgrip (122). Plate (140) comprises a detent (144) positioned proximal totrigger arm (135) when trigger (126) is in the initial position. Whentrigger (126) is pivoted proximally toward grip (122), trigger arm (135)passes detent (144) such that detent (144) is operable to provide atactile (and perhaps audible) warning. Detent (144) is positioned suchthat the tactile warning is provided just prior to actuator (131)compressing switch (170) to activate the bipolar RF energy. However,detent (144) is merely optional and other warning methods (e.g.,audible, visual, etc.) may be used to indicate the activation of bipolarRF energy. Other suitable warning features and methods will be apparentto one with ordinary skill in the art in view of the teachings herein.

B. Exemplary Operation

In an exemplary use, end effector (40) is inserted into a patient via atrocar.

Articulation section (36) is substantially straight when end effector(40) and part of shaft (30) are inserted through the trocar.Articulation control (28) may then be manipulated to pivot or flexarticulation section (36) of shaft (30) in order to position endeffector (40) at a desired position and orientation relative to ananatomical structure within the patient. Once end effector (40) ispositioned within the patient, jaws (42, 44) are opened. Trigger (126)is then at an initial position, as shown in FIG. 16A, such that trigger(126) is pivoted away from grip (122). In this position, actuator (131)is at a proximal position such that actuator (131) is decoupled fromswitch (170). As shown in FIG. 6, translation member (150) is also in aproximal position such that firing beam (190) is proximal and jaws (42,44) of end effector (40) are open.

Two layers of tissue of the anatomical structure are then capturedbetween jaws (42, 44) by squeezing trigger (126) toward pistol grip(122) through a first range of motion. When trigger (126) is pivotedtoward grip (122) through this first range of motion, protrusion (163)of pivot arm (160) translates with trigger arm (135) within channel(138). Pivot arm (160) thereby pivots around pin (128) of plate (140)such that the top portion of pivot arm (160) moves distally.Accordingly, protrusion (164) of pivot arm (160) translates translationmember (150) and firing beam (190) distally, as shown in FIG. 17. Asnoted above, flanges (62, 66) cammingly act to pivot jaw (42) toward jaw(44) when firing beam (190) is actuated distally by squeezing trigger(126) toward pistol grip (122). Jaws (42, 44) may be substantiallyclamping tissue before trigger (122) has swept through a full range ofmotion toward pistol grip (122), such that trigger (126) may continuepivoting toward pistol grip (122) through a second range of motion afterjaws (42, 44) have substantially clamped on the tissue. Detent (144)provides tactile feedback to the operator indicating that trigger (126)has completed the first range of motion.

It should be understood that protrusion (133) sweeps through firstrecess (125) during a first range of pivotal motion of trigger (126) asdescribed above, and that actuator (131) remains decoupled from switch(170) during this range of motion. Thus, electrodes (50, 52) remaininactive as trigger (126) pivots through the first range of motion. Thisensures that electrodes (50, 52) do not receive RF energy before tissueis clamped between jaws (42, 44). Once trigger (126) completes the firstrange of motion and has advanced firing beam (190) to the point wheretissue is clamped between jaws (42, 44), protrusion (133) reaches theproximal end of recess (125) such that further pivoting of trigger (126)through a second range of motion will drive actuator (131) distally inopening (124), to thereby active switch (170).

With tissue layers clamped between jaws (42, 44), firing beam (190)continues to advance distally by the user squeezing trigger (126)further toward pistol grip (122) through a second range of motion. Thisfurther pivoting of trigger (126) through the second range of motionactivates switch (170), as shown in FIG. 16B, to deliver bipolar RFenergy to electrodes (50, 52). In some versions, electrodes (50, 52) areselectively coupled with power source (80) (e.g., by depressing switch(170), etc.) such that electrode surfaces (50, 52) of jaws (42, 44) areactivated with a common first polarity while firing beam (190) isactivated at a second polarity that is opposite to the first polarity.Thus, a bipolar RF current flows between firing beam (190) and electrodesurfaces (50, 52) of jaws (42, 44), through the compressed regions ofsevered tissue layer portions. In some other versions, electrode surface(50) has one polarity while electrode surface (52) and firing beam (190)both have the other polarity. In either version (among at least someothers), bipolar RF energy delivered by power source (80) ultimatelythermally welds the tissue layer portions on one side of firing beam(190) together and the tissue layer portions on the other side of firingbeam (190) together.

The further pivoting of trigger (126) through the second range of motionalso causes firing beam (190) to continue advancing distally. As firingbeam (190) continues to advance distally, distal blade (64)simultaneously severs the clamped tissue layers, resulting in separatedupper layer portions being apposed with respective separated lower layerportions. In some versions, this results in a blood vessel being cut ina direction that is generally transverse to the length of the bloodvessel. It should be understood that the presence of flanges (62, 66)immediately above and below jaws (42, 44), respectively, may help keepjaws (42, 44) in a closed and tightly clamping position. In particular,flanges (62, 66) may help maintain a significantly compressive forcebetween jaws (42, 44).

End effector (40) may then be removed from the patient or repositionedto sever additional tissue. If end effector (40) is repositioned,trigger (126) may be released to open jaws (42, 44). Torsion spring(182) biases trigger (126) to the initial position and compressionspring (180) biases translation member (150) proximally to the initialposition, shown in FIGS. 6 and 16A. Accordingly, actuator (131) istranslated proximally within opening (124) to release switch (170), asshown in FIG. 16A, to thereby deactivate the RF energy. The proximaltranslation of translation member (150) pulls firing beam (190)proximally to open jaws (42, 44) of end effector (40). Accordingly, endeffector (40) may then be repositioned to sever additional tissue.

In some instances, it may be desirable to deactivate the RF energywithout opening jaws (42, 44) of end effector (40). After pivotingtrigger (126) toward grip (122) to activate the RF energy, the user mayslightly release trigger (126) to the position shown in FIG. 18. Trigger(126) is pivoted slightly away from grip (122) such that torsion spring(182) biases actuator (131) of trigger arm (135) proximally withinopening (124) to release switch (170). The decompression of switch (170)thereby deactivates the RF energy. Because trigger (126) was slightlyreleased from grip (122), translation member (150) remains at a distalposition such that firing beam (190) is still sufficiently advanced toclamp jaws (42, 44) together. Accordingly, the RF energy has beendeactivated from end effector (40) with jaws (42, 44) still closed.

III. Miscellaneous

It should be understood that any of the versions of electrosurgicalinstrument (10) described herein may include various other features inaddition to or in lieu of those described above. By way of example only,any of the devices herein may also include one or more of the variousfeatures disclosed in any of the various references that areincorporated by reference herein.

It should also be understood that any of the devices described hereinmay be modified to include a motor or other electrically powered deviceto drive an otherwise manually moved component. Various examples of suchmodifications are described in U.S. Pub. No. 2012/0116379, entitled“Motor Driven Electrosurgical Device with Mechanical and ElectricalFeedback,” published May 10, 2012, the disclosure of which isincorporated by reference herein. Various other suitable ways in which amotor or other electrically powered device may be incorporated into anyof the devices herein will be apparent to those of ordinary skill in theart in view of the teachings herein.

It should also be understood that any of the devices described hereinmay be modified to contain most, if not all, of the required componentswithin the medical device itself. More specifically, the devicesdescribed herein may be adapted to use an internal or attachable powersource instead of requiring the device to be plugged into an externalpower source by a cable. Various examples of how medical devices may beadapted to include a portable power source are disclosed in U.S.Provisional Application Ser. No. 61/410,603, filed Nov. 5, 2010,entitled “Energy-Based Surgical Instruments,” the disclosure of which isincorporated by reference herein. Various other suitable ways in which apower source may be incorporated into any of the devices herein will beapparent to those of ordinary skill in the art in view of the teachingsherein.

While the examples herein are described mainly in the context ofelectrosurgical instruments, it should be understood that variousteachings herein may be readily applied to a variety of other types ofdevices. By way of example only, the various teachings herein may bereadily applied to other types of electrosurgical instruments, tissuegraspers, tissue retrieval pouch deploying instruments, surgicalstaplers, surgical clip appliers, ultrasonic surgical instruments, etc.It should also be understood that the teachings herein may be readilyapplied to any of the instruments described in any of the referencescited herein, such that the teachings herein may be readily combinedwith the teachings of any of the references cited herein in numerousways. Other types of instruments into which the teachings herein may beincorporated will be apparent to those of ordinary skill in the art.

In versions where the teachings herein are applied to a surgicalstapling instrument, it should be understood that the teachings hereinmay be combined with the teachings of one or more of the following, thedisclosures of all of which are incorporated by reference herein: U.S.Pat. No. 4,805,823, entitled “Pocket Configuration for Internal OrganStaplers,” issued Feb. 21, 1989; U.S. Pat. No. 5,415,334, entitled“Surgical Stapler and Staple Cartridge,” issued May 16, 1995; U.S. Pat.No. 5,465,895, entitled “Surgical Stapler Instrument,” issued Nov. 14,1995; U.S. Pat. No. 5,597,107, entitled “Surgical Stapler Instrument,”issued Jan. 28, 1997; U.S. Pat. No. 5,632,432, entitled “SurgicalInstrument,” issued May 27, 1997; U.S. Pat. No. 5,673,840, entitled“Surgical Instrument,” issued Oct. 7, 1997; U.S. Pat. No. 5,704,534,entitled “Articulation Assembly for Surgical Instruments,” issued Jan.6, 1998; U.S. Pat. No. 5,814,055, entitled “Surgical ClampingMechanism,” issued Sep. 29, 1998; U.S. Pat. No. 6,978,921, entitled“Surgical Stapling Instrument Incorporating an E-Beam Firing Mechanism,”issued Dec. 27, 2005; U.S. Pat. No. 7,000,818, entitled “SurgicalStapling Instrument Having Separate Distinct Closing and FiringSystems,” issued Feb. 21, 2006; U.S. Pat. No. 7,143,923, entitled“Surgical Stapling Instrument Having a Firing Lockout for an UnclosedAnvil,” issued Dec. 5, 2006; U.S. Pat. No. 7,303,108, entitled “SurgicalStapling Instrument Incorporating a Multi-Stroke Firing Mechanism with aFlexible Rack,” issued Dec. 4, 2007; U.S. Pat. No. 7,367,485, entitled“Surgical Stapling Instrument Incorporating a Multistroke FiringMechanism Having a Rotary Transmission,” issued May 6, 2008; U.S. Pat.No. 7,380,695, entitled “Surgical Stapling Instrument Having a SingleLockout Mechanism for Prevention of Firing,” issued Jun. 3, 2008; U.S.Pat. No. 7,380,696, entitled “Articulating Surgical Stapling InstrumentIncorporating a Two-Piece E-Beam Firing Mechanism,” issued Jun. 3, 2008;U.S. Pat. No. 7,404,508, entitled “Surgical Stapling and CuttingDevice,” issued Jul. 29, 2008; U.S. Pat. No. 7,434,715, entitled“Surgical Stapling Instrument Having Multistroke Firing with OpeningLockout,” issued Oct. 14, 2008; U.S. Pat. No. 7,721,930, entitled“Disposable Cartridge with Adhesive for Use with a Stapling Device,”issued May 25, 2010; U.S. Pub. No. 2010/0264193, entitled “SurgicalStapling Instrument with An Articulatable End Effector,” published Oct.21, 2010; and U.S. Pub. No. 2012/0239012, entitled “Motor-DrivenSurgical Cutting Instrument with Electric Actuator Directional ControlAssembly,” published Sep. 20, 2012. Other suitable ways in which theteachings herein may be applied to a surgical stapling instrument willbe apparent to those of ordinary skill in the art in view of theteachings herein.

In versions where the teachings herein are applied to an ultrasonicsurgical instrument, it should be understood that some such instrumentsmay lack a translating firing beam. The components described herein fortranslating a firing beam may instead simply translate a jaw closingmember. Alternatively, such translating features may simply be omitted.In any case, it should be understood that the teachings herein may becombined with the teachings of one or more of the following: U.S. Pat.Pub. No. 2006/0079874, entitled “Tissue Pad for Use with an UltrasonicSurgical Instrument,” published Apr. 13, 2006, the disclosure of whichis incorporated by reference herein; U.S. Pat. Pub. No. 2007/0191713,entitled “Ultrasonic Device for Cutting and Coagulating,” published Aug.16, 2007, the disclosure of which is incorporated by reference herein;U.S. Pat. Pub. No. 2007/0282333, entitled “Ultrasonic Waveguide andBlade,” published Dec. 6, 2007, the disclosure of which is incorporatedby reference herein; U.S. Pat. Pub. No. 2008/0200940, entitled“Ultrasonic Device for Cutting and Coagulating,” published Aug. 21,2008, the disclosure of which is incorporated by reference herein; U.S.Pat. Pub. No. 2011/0015660, entitled “Rotating Transducer Mount forUltrasonic Surgical Instruments,” published Jan. 20, 2011, thedisclosure of which is incorporated by reference herein; U.S. Pat. No.6,500,176, entitled “Electrosurgical Systems and Techniques for SealingTissue,” issued Dec. 31, 2002, the disclosure of which is incorporatedby reference herein; U.S. Pat. Pub. No. 2011/0087218, entitled “SurgicalInstrument Comprising First and Second Drive Systems Actuatable by aCommon Trigger Mechanism,” published Apr. 14, 2011, the disclosure ofwhich is incorporated by reference herein; and/or U.S. Pat. No.6,783,524, entitled “Robotic Surgical Tool with Ultrasound Cauterizingand Cutting Instrument,” issued Aug. 31, 2004, the disclosure of whichis incorporated by reference herein. Other suitable ways in which theteachings herein may be applied to an ultrasonic surgical instrumentwill be apparent to those of ordinary skill in the art in view of theteachings herein.

It should be understood that any one or more of the teachings,expressions, embodiments, examples, etc. described herein may becombined with any one or more of the other teachings, expressions,embodiments, examples, etc. that are described herein. Theabove-described teachings, expressions, embodiments, examples, etc.should therefore not be viewed in isolation relative to each other.Various suitable ways in which the teachings herein may be combined willbe readily apparent to those of ordinary skill in the art in view of theteachings herein. Such modifications and variations are intended to beincluded within the scope of the claims.

It should be appreciated that any patent, publication, or otherdisclosure material, in whole or in part, that is said to beincorporated by reference herein is incorporated herein only to theextent that the incorporated material does not conflict with existingdefinitions, statements, or other disclosure material set forth in thisdisclosure. As such, and to the extent necessary, the disclosure asexplicitly set forth herein supersedes any conflicting materialincorporated herein by reference. Any material, or portion thereof, thatis said to be incorporated by reference herein, but which conflicts withexisting definitions, statements, or other disclosure material set forthherein will only be incorporated to the extent that no conflict arisesbetween that incorporated material and the existing disclosure material.

Versions of the devices described above may have application inconventional medical treatments and procedures conducted by a medicalprofessional, as well as application in robotic-assisted medicaltreatments and procedures. By way of example only, various teachingsherein may be readily incorporated into a robotic surgical system suchas the DAVINCI™ system by Intuitive Surgical, Inc., of Sunnyvale, Calif.Similarly, those of ordinary skill in the art will recognize thatvarious teachings herein may be readily combined with various teachingsof U.S. Pat. No. 6,783,524, entitled “Robotic Surgical Tool withUltrasound Cauterizing and Cutting Instrument,” published Aug. 31, 2004,the disclosure of which is incorporated by reference herein.

Versions described above may be designed to be disposed of after asingle use, or they can be designed to be used multiple times. Versionsmay, in either or both cases, be reconditioned for reuse after at leastone use. Reconditioning may include any combination of the steps ofdisassembly of the device, followed by cleaning or replacement ofparticular pieces, and subsequent reassembly. In particular, someversions of the device may be disassembled, and any number of theparticular pieces or parts of the device may be selectively replaced orremoved in any combination. Upon cleaning and/or replacement ofparticular parts, some versions of the device may be reassembled forsubsequent use either at a reconditioning facility, or by a userimmediately prior to a procedure. Those skilled in the art willappreciate that reconditioning of a device may utilize a variety oftechniques for disassembly, cleaning/replacement, and reassembly. Use ofsuch techniques, and the resulting reconditioned device, are all withinthe scope of the present application.

By way of example only, versions described herein may be sterilizedbefore and/or after a procedure. In one sterilization technique, thedevice is placed in a closed and sealed container, such as a plastic orTYVEK bag. The container and device may then be placed in a field ofradiation that can penetrate the container, such as gamma radiation,x-rays, or high-energy electrons. The radiation may kill bacteria on thedevice and in the container. The sterilized device may then be stored inthe sterile container for later use. A device may also be sterilizedusing any other technique known in the art, including but not limited tobeta or gamma radiation, ethylene oxide, or steam.

Having shown and described various embodiments of the present invention,further adaptations of the methods and systems described herein may beaccomplished by appropriate modifications by one of ordinary skill inthe art without departing from the scope of the present invention.Several of such potential modifications have been mentioned, and otherswill be apparent to those skilled in the art. For instance, theexamples, embodiments, geometrics, materials, dimensions, ratios, steps,and the like discussed above are illustrative and are not required.Accordingly, the scope of the present invention should be considered interms of the following claims and is understood not to be limited to thedetails of structure and operation shown and described in thespecification and drawings.

I/We claim:
 1. An apparatus for operating on tissue, the apparatuscomprising: (a) an end effector, wherein the end effector comprises: (i)a first jaw, (ii) a second jaw, wherein the first jaw is pivotablerelative to the second jaw, wherein the first jaw is configured to pivotfrom an open position to a closed position, wherein one or both of thefirst jaw or the second jaw is operable to deliver energy to tissue, and(iii) a cutting member operable to sever tissue captured between thefirst and second jaws; (b) a first actuator, wherein the first actuatoris movable from a first position to a second position, wherein the firstactuator is operable to pivot the first jaw from the open position tothe closed position when the first actuator is moved from the firstposition to the second position, wherein the first actuator is furtheroperable to drive the cutting member when the first actuator is movedfrom the second position to a third position; and (c) a second actuator,wherein the first actuator is configured to engage the second actuatorwhen the first actuator is in the second position, wherein the secondactuator is operable to selectively energize the one or both of thefirst jaw or the second jaw to deliver energy to tissue when the firstactuator is engaged with the second actuator.
 2. The apparatus of claim1 further comprising a handpiece, wherein the first and second actuatorsare positioned within the handpiece.
 3. The apparatus of claim 2,wherein the first actuator is movable within an opening of thehandpiece.
 4. The apparatus of claim 2, wherein the second actuatorcomprises a switch.
 5. The apparatus of claim 4, wherein the switch ispositioned within an opening of the handpiece.
 6. The apparatus of claim2, wherein the handpiece comprises a trigger pivotable relative to thehandpiece, wherein the first actuator is positioned on a top portion ofthe trigger.
 7. The apparatus of claim 6 further comprising a pivot arm,wherein the pivot arm is pivotable relative to the handpiece, whereinthe pivot arm is coupled with the trigger such that the trigger isoperable to pivot the pivot arm relative to the handpiece.
 8. Theapparatus of claim 7 further comprising a translation member, whereinthe translation member is coupled with the pivot arm such that the pivotarm is operable to translate the translation member relative to thehandpiece.
 9. The apparatus of claim 8 further comprising a firing beam,wherein the firing beam is coupled with a distal end of the translationmember, wherein the translation member is operable to translate thefiring beam.
 10. The apparatus of claim 9, wherein the cutting member ispositioned at the distal end of the firing beam.
 11. The apparatus ofclaim 8, further comprising a resilient member coupled with thetranslation member such that the resilient member is operable to biasthe translation member to a proximal position.
 12. The apparatus ofclaim 2, wherein the handpiece comprises an indicator operable toindicate that the first actuator is moving from the first position tothe second position.
 13. The apparatus of claim 12, wherein theindicator is a detent positioned within the handpiece.
 14. The apparatusof claim 1, wherein the first actuator comprises a protrusion, whereinthe protrusion is operable to prevent the first actuator from engagingthe second actuator prior to the first jaw pivoting to the closedposition.
 15. The apparatus of claim 1, wherein the first actuator isconfigured to disengage the second actuator while the first jaw is inthe closed position.
 16. The apparatus of claim 1, wherein the one orboth of the first jaw or the second jaw is operable to deliver RF energyto tissue, wherein the second actuator is operable to selectivelyenergize the one or both of the first jaw or the second jaw to deliverRF energy to tissue when the first actuator is engaged with the secondactuator.
 17. An apparatus for operating on tissue, the apparatuscomprising: (a) an end effector, wherein the end effector comprises afirst jaw and a second jaw, wherein the first jaw is pivotable relativeto the second jaw, wherein the first jaw is configured to pivot from anopen position to a closed position; (b) a first actuator, wherein thefirst actuator is pivotable from a distal position to a proximalposition, wherein the first actuator is operable to pivot the first jawfrom the open position to the closed position when the first actuator ispivoted from the distal position to the proximal position; (c) a secondactuator coupled with the first actuator, wherein the second actuator istranslatable from a proximal position to a distal position when thefirst actuator is pivoted from the distal position to the proximalposition; and (d) a third actuator, wherein the second actuator isconfigured to actuate the third actuator when the second actuator is inthe distal position, wherein the third actuator is operable toselectively provide RF energy to the end effector.
 18. A method ofoperating an apparatus, the apparatus comprising an end effector havinga first and second jaw, a first actuator, and a second actuator, themethod comprising: (a) positioning the first and second jaws of the endeffector around tissue; (b) actuating the first actuator through a firstrange of motion to pivot the first jaw toward the second jaw to clampthe tissue between the first and second jaws; and (c) actuating thefirst actuator through a second range of motion to actuate the secondactuator, wherein the second actuator provides RF energy to the endeffector to weld the tissue.
 19. The method of claim 18, furthercomprising actuating the first actuator through a third range of motionto sever the tissue clamped between the first and second jaws of the endeffector.
 20. The method of claim 18, further comprising reversing thefirst actuator to de-actuate the second actuator such that the secondactuator deactivates the RF energy to the end effector while the firstjaw remains pivoted toward the second jaw.